FAQ's

Questions and Answers

Men, don't be embarrassed to ask.
In my 20 years of practicing urology I have learned that many men are reluctant to go to the doctor. When they do go they can be shy or embarrassed to discuss matters related to their sexuality. Viagra commercials have normalized things somewhat, so they are more comfortable in asking for a prescription of Viagra, Levitra or Cialis.

All of these issues are extremely common -- and the good news is there are excellent, effective remedies available.

Viagra, Levitra or Cialis don't work for everyone or in some men they cause unacceptable side effects. Some men take other medicines that can negatively interact with these pills or have medical conditions that make it dangerous to take these pills.

Testosterone replacement for the right individual enhances energy, mood, libido, sexual function, vitality, memory, strength of muscle and bones. It has been shown to be good for the heart, cholesterol and may allow men to actually live longer.

Most men like to ejaculate and different conditions including low hormones can lead to a decrease in the amount of fluid produced. An enlarged prostate can also be a cause of low ejaculatory volume. Certain medications or surgeries can cause retrograde ejaculation, where the fluid shoots back into the bladder instead of to the outside.

Many men wish they can last a long time pleasuring their partner. There are some men who have very little control on when they climax. This can be an area of embarrassment and relationship problems. Some men will climax seconds after vaginal penetration or a minute or two and this has been going on for years. One cause can be low levels of a certain hormone in the brain called serotonin. This is supported by the fact hat sometimes certain medicines used for depression can help with premature ejaculation. This category of medicines are called SSRIs (selective serotonin reuptake inhibitors). There are several other remedies for PE including anesthetic creams, vacuum pumps as well as penile injections.

Some men discover a bend in their penis with or without pain. This is caused by scar tissue that develops in the wall of the cylinders of the penis. (the wall is called the tunica albuginea). Some cases are so severe that penetration is not possible. There are effective treatments including creams, pills and injections to soften up the scar tissue. There has been encouraging results with a new penile traction device. In some cases surgery is necessary to straighten the penis.

Some men are in sexless relationships because they are no longer interested in sex. This is usually due to low levels of testosterone or too high levels of estrogen (female hormone). Yes men have both male and female hormones and men feel and function the best when their male hormone is high and female hormone low.